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A Cost-Effectiveness Analysis of Intravitreal Aflibercept for the Prevention of Progressive Diabetic Retinopathy
- Source :
- Ophthalmology Retina. 6:213-218
- Publication Year :
- 2022
- Publisher :
- Elsevier BV, 2022.
-
Abstract
- Purpose To calculate costs required to prevent center-involved diabetic macular edema (CI-DME) or proliferative diabetic retinopathy (PDR), and to improve the diabetic retinopathy severity score (DRSS) with intravitreal anti-VEGF injections as reported for aflibercept in two randomized control trials. Design Cost-effectiveness analysis modeling based on published data Subjects None Methods Results from PANORAMA and the Diabetic Retinopathy Clinical Research Network ( DRCR.net ) Protocol W were analyzed. Parameters collected included DRSS score, risk reduction of PDR, risk reduction of CI-DME, and number of treatments required. Costs were modeled based on 2020 Medicare reimbursement data practice settings of hospital-based facility and non-facility. Main Outcome Measure Cost to prevent case of PDR and CI-DME, and to improve DRSS stage Results Over 2 years in Protocol W, the cost required to prevent 1 case of PDR was $83,000 ($72,400) in the facility (non-facility) setting; in PANORAMA, the corresponding 2 year costs were $89,400 ($75,000) for the 2Q16 arm, and $91,200 ($89,900) for the 2Q8PRN arm. To prevent 1 case of CI-DME with vision loss in Protocol W, the cost was $154,000 ($133,000). For all CI-DME, with and without vision loss; in PANORAMA, the costs to prevent a case were $70,900 ($59,500) for the 2Q16 arm, and $90,000 ($88,800) for the 2Q8PRN arm. In Protocol W, the overall accumulated total for cost /DRSS unit change at the 2 year point for facility (non-facility) setting was $2700 ($2400)/DRSS. In the first year alone, it was $2100 ($1800)/DRSS and in the second year alone, $6100 ($5300)/DRSS. Conclusion There is a considerable cost associated with the prevention of PDR and CI-DME with intravitreal aflibercept injections. A price per unit of change in diabetic retinopathy severity score is a new parameter which might serve as a benchmark in future utility analyses that could be used to bring perspective to cost-utility considerations.
- Subjects :
- Vascular Endothelial Growth Factor A
medicine.medical_specialty
Cost-Benefit Analysis
Recombinant Fusion Proteins
Diabetic macular edema
Visual Acuity
Medicare
Macular Edema
law.invention
Randomized controlled trial
law
Ophthalmology
Diabetes Mellitus
Humans
Medicine
Aged
Aflibercept
Cost–utility analysis
Diabetic Retinopathy
business.industry
Outcome measures
Diabetic retinopathy
Cost-effectiveness analysis
medicine.disease
United States
eye diseases
Receptors, Vascular Endothelial Growth Factor
Clinical research
Emergency medicine
business
medicine.drug
Subjects
Details
- ISSN :
- 24686530
- Volume :
- 6
- Database :
- OpenAIRE
- Journal :
- Ophthalmology Retina
- Accession number :
- edsair.doi.dedup.....b94c6d565f385f6597d65e7c232953f8